Internist as patient advocate: You can make a difference

Last year, one of my U.S. senators was instrumental in getting legislation passed in Congress that reversed the scheduled Medicare fee cuts.

I like to think that the visits that I and other ACP members have made to Capitol Hill had something to do with that. I am not so naïve as to believe my input always has a significant impact on how my representatives and senators vote--in fact, I follow their voting records and know we're sometimes at odds. But I have seen them back enough critical legislation to know that ACP members can make a difference.

This month, you can go to bat for issues important to internists by participating in ACP's Leadership Day in Washington, May 16-17. It is an invaluable opportunity to discuss how health policy issues affect our practices and our increasingly aging, diverse patient populations. (See "Sign up now for Leadership Day.")

Leadership Day is a chance to give lawmakers input on the often-dysfunctional payment system, health information technology, coverage for the uninsured, and resources for graduate medical education and biomedical and health services research. ACP members who come to Washington and meet with policy-makers are a crucial component of the College's ongoing advocacy efforts.

Broad-based advocacy

Back when I was in medical school and residency, I had no idea that I would ever feel a need to go to Washington to help my patients. I now believe, however, that it is part of my professional responsibility to advocate for my patients on many different levels.

I now believe that it is part of my professional responsibility to advocate for my patients.

Each time I attend Leadership Day, I feel I'm on that middle-school field trip to Washington that I never had. I continue to be awed by the majesty of our nation's capitol, the importance of the issues we discuss, the caliber of speakers who flag health policy trends, and the willingness of my legislators (or their health legislative assistants) to listen to what I have to say.

Even though some of those assistants look no older than my college-age children, they are knowledgeable about health policy. They are also genuinely interested in the policy information we bring them from the College and from our practice back home. They frequently ask for additional information and follow up on our ideas.

If you don't have the time or interest to go to Washington, you can still advocate in your own community. Here are options to consider:

Join the College's Key Contact program. When you sign up as a Key Contact, you will be notified by e-mail of upcoming important votes and of the role your senator or representative plays on different committees. By using ACP's online Legislative Action Center, it takes less than two minutes to send an e-mail or fax to your federal legislators. (You can sign up for the Key Contact program online.

Meet locally. Both federal and state legislators have offices in their home district and meet with constituents at local meetings. You can attend these meetings or contact your representatives and their staff at their local office. You may even choose to donate to the campaigns of candidates you strongly support and attend fundraisers for them.

Get involved with your ACP chapter. Most College chapters have health and public policy committees, while some have active state legislative advocacy and Key Contact programs similar to those at the national level. Contact your chapter or visit its Web site to find out how to be notified when your state legislature has a big vote coming up.

Advocate in your community. Advocacy efforts extend far beyond the legislative process. Physicians often lobby within their own community, health care system or practice to improve the quality or efficiency of care or to broaden care access.

In fact, internists are more likely than other specialists to serve in leadership roles in health systems, hospitals and academic health centers. In ACP's 2005 membership survey, 59% of those surveyed were involved in the management of their practice. That type of leadership allows us to identify ways to improve care and work to make that change.

Find ways to help your patients. You can improve patient care by working with an insurance company to get reimbursement for a service your patients need or by establishing a system in your office to help patients fill out forms to qualify for pharmaceutical assistance programs. These are all activities we perform several times a day—and they are all essential forms of patient advocacy.

Maybe this year

One of the College's missions is to foster excellence in the practice of medicine. In acting as advocates, we are more likely to identify those system issues that prevent patients from receiving the best possible care. That brings us closer to removing those barriers for our patients and ourselves.

The same U.S. senator who worked to reverse the Medicare fee cuts also understands the need to replace the sustainable growth rate formula with a more equitable way to calculate physician reimbursement.

In our meeting with my senator and her staff this month, my colleagues and I will present what we believe are better alternatives—and maybe key legislation will get passed this year. In the meantime, I'll be meeting an essential obligation to my patients and adding significantly to my own professional satisfaction.

ACP members are coming to Capitol Hill May 16-17 for ACP's annual Leadership Day event, a chance to meet with Congressional representatives and let them know how legislative and regulatory actions affect your practice.

Sign up now to attend, and contact your Chapter Governor to coordinate participation. A full roster of the day's events and a registration form are online.

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